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Chemoprophylaxis for malaria in Uganda
Published by: mike 2009-01-08

  • a anndd tthheeiirr iimmpplliiccaattiioonnss ffoorr ppuubblliicc h ::
    for the prevention of malaria in In areas of stable transmission, malaria accounts for up to Ugandaan area with stable malariaindicates that
    http://www.who.int/malaria/malaria_HIV/MalariaHIVinteractions_report.pdf
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    Which medicine or medicines would be considered the most suitable - most effective with least side effects - to take for the prevention of malaria for someone visiting Uganda in East Africa for a two week holiday. Is the new drug malarone safe to take? Is it safe to give to a 5 year old?
  • Cluster of Falciparum Malaria Cases in UK Airport::
    A group of 30 US citizens spent June and July 2005 in Kenya and Uganda as part of an person did not continue using chemoprophylaxis for the full period at risk.
    http://www.cdc.gov/eid/content/14/8/pdfs/08-0031.pdf
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  • As Malarone has been recommended, let me quickly point out that the efficacy of this drug may be limited if certain other drugs are taken at the same time. This includes Tetracyclines (certain type of antibiotics, e.g. Doxycycline), Metoclopramide (given against nausea, often prescribed to patients suffering from migraine), Rifampicine (prescribed in tuberculosis) and Rifabutine (tuberculosis, AIDS). Drug interactions are something that is often forgotten about, unfortunately.
  • CHEMOPROPHYLAXIS ACCORDING TO THE GUIDELINES ON MALARIA PREVENTION FOR ::
    been licensed and registered in Japan for chemoprophylaxis against malaria since M Uganda (3 y) 13. 34. F Around Asia (4 m) 14. 34. M Around Asia (4 m)
    http://www.tm.mahidol.ac.th/seameo/2006_37_spp3/37sup3_11.pdf
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  • There is really nothing wrong with giving Malarone to Kids. There is even a special formulation for children - Malarone Pediatric: http://www.accessdata.fda.gov/scripts/cder/ob/docs/temptndet.cfm?Appl_No=021078&TABLE1=Rx Malarone has FDA approval for Children from 11 kg. Your 5 year old should already weigh more than that. For children weighing less than 11 kg, there simply is no study data available yet, which is why it is not recommended. As to the comment you made how Malarone was not to be given to children: one website does mention this, but refers to the UK and only states, that the drug is only LICENSED there from 40 kg of body weight. The same is true for Germany right now, but I found reference that from the end of 2002, it will be approved to be used for smaller children there as well. It really seems to merely be a license problem. http://www.pharmazeutische-zeitung.de/pza/2002-17/pharm5.htm


  • This was an adequate response. You gave me the tools to work with. I didn't think you answered the question for me. I felt that you made up your mind early on that Malarone was the answer. This gave you a blinkered approach to the topic. When I started checking the websites, one of them specifically mentions that Malarone is not to be given to children. So Malarone was not the answer for my 5 year old!. But you did put me on the right path.
  • THE USE OF ANTIMALARIAL DRUGS::
    are no longer recommended for chemoprophylaxis in travellers because of the sulfa drug-pyrimethamine combinations for malaria treatment in pregnant women
    http://www.rbm.who.int/cmc_upload/0/000/014/923/am2_1-3.htm
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  • The following table shows the treatment doses for kids: (Sorry for the poor formatting. We can t use formatting options here) "Table 1. Pediatric Treatment Doses of Malarone™ Body Weight*(pounds) BodyWeight*(kilograms) Atovaquone/Proguanil HCl Total Daily Dose Dosage Regimen 24–45 11–20 250 mg/100 mg 1 adult tablet daily for 3 consecutive days 46–67 21–30 500 mg/200 mg 2 adult tablets (as a single dose) daily for 3consecutive days " from: CDC Malarone for Malaria .. ( http://www.cdc.gov/travel/diseases/malaria/malarone.htm ) Usually a kid of 5 years should weigh about 19 Kilograms. So I can t understand why Malarone should not be suitable for your son. till-ga


  • Malarone seems to be a very good choice for prophylaxis of malaria. All sources I found say it s an effective and safe agent for the prophylaxis of malaria. The only minor disadvantage seems to be the price. “Malarone TM. This is a combination of atovaquone and proguanil and recent studies have found it a safe and effective prophylactic agent with few side affects. Unfortunately it is expensive (~US$42 for 12 tablets) and has to be taken daily. It is not suitable for those sensitive to atovaquone or proguanil . Treatment should be started 2 days before travel and continued for 7 days after the travel period.” from: Malaria Prophylaxis ( http://www.rph.wa.gov.au/labs/haem/malaria/prophylaxis.html ) “Malarone appears to be extremely well tolerated with fewer side effects than other available medications. Side effects may include GI upset or headache. This contrasts with neuro-psychiatic side-effects of mefloquine and GI upset and sun sensitivity with doxycycline. Malarone has been available in Denmark since 1998 and was approved for use in the United States in August, 2000. The drug combination has been used in Denmark for the past year with an excellent safety record. Malarone is not licensed for pregnant women or nursing mothers.” from: MCW Health Link ( http://healthlink.mcw.edu/article/979237802.html ) “Treatment Malarone has been shown to be highly efficacious in the treatment of uncomplicated malaria caused by Plasmodium falciparum, including malaria that has been acquired in areas with chloroquine-resistant or multidrug-resistant strains.” It seems to be safe for adults and kids: “Malarone is available in adult (250 milligram [mg] atovaquone and 100 mg proguanil hydrochloride per tablet) and pediatric (62.5 mg atovaquone and 25 mg proguanil hydrochloride per tablet) strength forms. The daily dose should be taken at the same time each day with food or milk.” Especially Uganda is listed as a country where Malarone can and should be used: “ Malarone is the drug of choice for presumptive self-treatment for travelers to areas with SP-resistant malaria, including the following areas: Amazon Basin of South America Southeast Asia Some countries in eastern and southern Africa: specifically, Kenya, Malawi, Mozambique, South Africa, Tanzania, and Uganda.” There seem to be some adverse reactions: “The most common adverse effects reported in people using Malarone for prophylaxis or treatment were abdominal pain, nausea, vomiting, and headache.”, but I could not find data about the frequency. “For further questions related to the use of Malarone, CDC may be contacted (Malaria Hotline: 888-232-3228).” all from: CDC Malarone for Malaria Treatment and Prophylaxis ( http://www.cdc.gov/travel/diseases/malaria/malarone.htm ) However - as mentioned before - Malarone is rather expensive: “ The cost of Malarone is more expensive than other commonly used medications for malaria prophylaxis. Doxycycline costs pennies per day. Lariam (mefloquine) and Malarone are considerably more expensive; coverage for a two week trip using Malarone daily or Larium weekly may cost between $75 and $100. Malarone becomes more expensive than Larium after two weeks because it requires a daily pill whereas Larium is taken weekly. The price per pill decreases as more pills are purchased and pharmacies have considerable variance in pricing.” from: MCW Health Link ( http://healthlink.mcw.edu/article/979237802.html ) You ll find a comparison of the different drugs used at: Drugs most commonly used for Malaria Prevention ( http://geo.ya.com/travelimages/health-malaria-drugs.html ) Search Strategy ( ://www.google.de/search?sourceid=navclient&hl=de&querytime=MVNBR&q=malaria+prophylaxis+malarone ) till-ga





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